Meralgia Paresthetica

This is latin for “pain and numbness of the thigh”. 

What is Meralgia Paresthetica (MP) ?

MP is a mechanical problem when the nerve coming out the front of the hip gets compressed/pinched. This nerve is called the lateral femoral cutaneous nerve. The nerve gets squeezed as it passes through the abdominal wall muscle and under the inguinal ligament (fibrous tissue that connects bones to other bones).

“Lateral”  = outside    “Femoral” = femur (thigh)  “Cutaneous” = skin

What is the “Lateral Femoral Cutaneous Nerve”?

It is a pure sensory nerve providing feeling (touch and temperature sensation) to the top and outer side of the thigh. It is not responsible for any muscle movements. Even if the nerve function were totally lost, it would not affect the ability to walk or run because this nerve doesn’t control any muscles.

What are the symptoms of Meralgia Paresthetica?

The symptoms vary over time and between people.  For some people it is just numbness on the thigh.  Sometimes it’s a tingling sensation like when your foot falls asleep.  Misfiring nerve signals can also create odd sensations like itching or a sensation of water running down your thigh. Sometimes it can be painful.  That can either be an aching, burning, or shooting pain.

It usually involves one side, but in 20% of people it can involve both sides.

How common is meralgia paresthetica?

MP is very common. About 400 Manitobans get meralgia paresthetica every year.

What are the risk factors for Meralgia Paresthetica?

Abdominal obesity (having a large abdomen) is the most common reason/contributing factor. Diabetes and alcohol use reduces the health of nerves in general and predisposes the nerves to injury.

Like many things it is more common as people age (50 years and older).

How is MP diagnosed?

Usually your story and description of the area affected gives the diagnosis away. Reduced touch sensation in the affected areas on physical examination by your doctor confirms the diagnosis.

Your doctor will also examine your strength and reflexes in the legs which should be normal in this condition.

Are there any tests needed to diagnose MP?

No blood tests, x-rays, or MRIs are needed. Sometimes your doctor will order nerve tests (EMG and nerve conduction studies) to make sure it’s not a different nerve problem.

What will happen if I do nothing?

Research suggests that 85% of cases will go away within 4 to 6 months. In some people where the pinched nerve gets worse, it will go from burning and tingling to just numbness (lack of feeling) on the outer thigh.

This pinched nerve should never affect your walking or spread to other parts of your leg.  If you get new symptoms in a different area, you should talk to your doctor.

My meralgia is painful. Is there anything I can do?

Other than trying to protect the nerve and avoid more injury there are other options for treating the pain:

• Prescription nerve pain creams can be rubbed on the painful area and offers some benefit.
• Medications for nerve pain can be prescribed by your doctor but needs to be taken every day.
• Injections of corticosteroid (to reduce inflammation) can be injected around the nerve. These are usually done in this clinic under ultrasound guidance.
• Very rarely surgery is necessary by either cutting the nerve (Neurectomy) or making more room around the nerve (decompression).

What can I do to protect the nerve and stop it from getting worse?

While not a quick option, abdominal obesity is the greatest association with this condition so losing weight when possible is always reasonable to attempt. Things that make nerve health worse like poor diabetes control and alcohol should be avoided.

What tends to aggravate the nerve is anything that puts pressure in the groin or front of your hip. Tight belts or even underwear that’s tight on the thigh or pants that are tight and bunch up in the groin can contribute. Some people have a habit of leaning against a table with the hip (avoid this) For some people standing or sitting for too long brings on the symptoms so that people have to change positions to relieve the tingling/numb sensations. Some people find that holding their stomach in (sucking in their gut) helps take pressure off the nerve so that the leg feels better.

Most people with this condition choose to do no medical treatment rather than risk costs and side effects of medications and injections.  As long as you can live with the discomfort eventually the nerve burns itself out so that it is no longer painful, and you are simply left with a patch of numbness on the thigh.  While this might feel weird, it won’t affect your function.